Optical glucometer

ABSTRACT

Disclosed herein are devices and methods for detecting blood glucose levels in a subject that involve passively quantifying mid-infrared emissions from the eye of the subject.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation application of U.S. Utility patentapplication Ser. No. 16/660,041, filed Oct. 22, 2019, which is acontinuation of U.S. Utility patent application Ser. No. 16/084,880,filed on Sep. 13, 2018, now U.S. Pat. No. 10,492,714, which is a 371International application of PCT/US17/052467, filed on Sep. 20, 2017that claims priority to U.S. Provisional Patent Application No.62/397,181, filed on Sep. 20, 2016. The disclosure of each of theforegoing patent applications is expressly incorporated herein byreference in its entirety.

TECHNICAL FIELD

This invention relates to non-invasive optical methods and devices formeasuring blood glucose concentrations.

BACKGROUND

Many diabetics are asked to test their blood glucose up to six times ormore per day in order to adjust their insulin doses for tighter controlof their blood glucose levels. As a result of the discomfort, many ofthese patients do not test as often as is recommended by theirphysician, with the consequence of poor blood glucose control. This poorcontrol has been shown to result in increased complications from thisdisease. Among these complications are blindness, heart disease, kidneydisease, ischemic limb disease, and stroke. It would thus be desirableto obtain fast and reliable measurements of blood glucose concentrationusing easier and less invasive methods.

D-Glucose or Dextrose monohydrate is a simple molecule with the chemicalformula of C₆H₁₂O₆ yet determining the concentration in blood usingoptical methods is complex. This molecule has signature vibrationalmodes in the infrared region of the electromagnetic spectrum. Thesevibrational bands allow for spectral identification of the molecule. Inthe region of interest 980-1200 cm⁻¹, these spectral peaks areattributed to the C—O stretch in the glucose molecule.

SUMMARY

Disclosed herein are devices and methods for detecting blood glucoselevels in a subject that involve passively quantifying mid-infraredemissions from the eye of the subject. In some embodiments, themid-infrared emissions are quantified at a wavelength of 8 to 11 μm. Thedevices and methods can then involve comparing the mid-infraredemissions to control values (e.g. control values standardized to glucoselevels) to detect glucose levels in the eye.

An example apparatus for detecting blood glucose levels in a subject isdescribed herein. The apparatus includes a thermographic imaging deviceconfigured to capture mid-infrared (MIR) electromagnetic emissions, anda computing device communicatively connected to the thermographicimaging device. The computing device includes a processor and memoryoperably connected to the processor, where the memory hascomputer-executable instructions stored thereon. The computing device isconfigured to receive a plurality of images of the subject's eyecaptured by the thermographic imaging device, calculate an averageradiance value for a pixel region of interest using the plurality imagesof the subject's eye, correct the average radiance value for the pixelregion of interest based on a temperature of the subject's eye at thetime of image capture, and correlate the corrected average radiancevalue for the pixel region of interest to a blood glucose value of thesubject.

In some implementations, the plurality of images is four images.

Alternatively or additionally, the MIR electromagnetic emissions are ina wavelength range from about 9 μm to about 11 μm. Optionally, the MIRelectromagnetic emissions are in a wavelength range from about 9.7 μm toabout 10.3 μm.

Alternatively or additionally, the step of calculating the averageradiance value for the pixel region of interest includes calculating arespective average radiance value in the pixel region of interest foreach of the plurality of images. The average radiance value for thepixel region of interest is an average value of the respective averageradiance values.

Alternatively or additionally, the thermographic imaging device is aninfrared camera. In some implementations, the thermographic imagingdevice is a microbolometer. Optionally, the microbolometer is a vanadiumoxide (VOX) or amorphous silicon (a-Si) microbolometer. Alternatively oradditionally, the microbolometer includes a focal plane array of about100×100 active pixels.

Alternatively or additionally, the step of correcting the averageradiance value for the pixel region of interest based on the temperatureof the subject's eye at the time of image capture includes scaling theaverage radiance value for the pixel region of interest to acorresponding radiance value at about 33.5° C.

Alternatively or additionally, the step of correlating the correctedaverage radiance value for the pixel region of interest to the bloodglucose value of the subject includes querying a database to obtain theblood glucose value of the subject corresponding to the correctedaverage radiance value for the pixel region of interest.

Alternatively or additionally, the step of correlating the correctedaverage radiance value for the pixel region of interest to the bloodglucose value of the subject further includes using a search algorithmto identify a most probable blood glucose value of the subjectcorresponding to the corrected average radiance value for the pixelregion of interest.

Alternatively or additionally, the apparatus further includes a frameconfigured to align a sensor of the thermographic imaging device infront of the subject's eye, and a collimating ring limiting a field ofview of the sensor to a defined region about the center of the subject'seye. The collimating ring defines the distance from the detector to thesubject's eye.

Alternatively or additionally, the system is incorporated into ahandheld electronic device.

An example method for detecting blood glucose levels in a subject isdescribed herein. The method includes capturing, using a thermographicimaging device, a plurality of images of the subject's eye, calculating,using a computing device, an average radiance value for a pixel regionof interest based on the plurality images of the subject's eye,correcting, using the computing device, the average radiance value forthe pixel region of interest based on a temperature of the subject's eyeat the time of image capture, and correlating, using the computingdevice, the corrected average radiance value for the pixel region ofinterest to a blood glucose value of the subject.

In some implementations, the method further includes transmitting theplurality of images of the subject's eye to the computing device over acommunication link.

In some implementations, the method further includes assaying a bloodsample from the subject to measure blood glucose level if an abnormalglucose value is returned in response the correlation step.

In some implementations, the method further includes adjusting glucoselevel in the subject based on the glucose value returned in response thecorrelation step.

Another example method for detecting blood glucose levels in a subjectis described herein. The method includes passively quantifyingmid-infrared (MIR) electromagnetic emissions from the eye of thesubject, and comparing the MIR emissions to standard control values toestimate glucose levels in the eye.

In some implementations, the MIR emissions are detected at a wavelengthof about 8 to 11 μm. Optionally, the MIR emissions are detected at awavelength of about 10 μm.

Alternatively or additionally, the MIR emissions are detected using abolometer-type infrared imaging device.

Alternatively or additionally, the MIR emissions are detected using amicrobolometer infrared camera.

Alternatively or additionally, the method includes assaying a bloodsample from the subject to measure blood glucose levels if abnormalglucose levels are estimated.

Alternatively or additionally, the method further includes adjustingglucose levels in the subject based on the estimated glucose levels.

An example blood-glucose detection apparatus is described herein. Theapparatus includes a mid-infrared (MIR) electromagnetic emissions sensorhaving a field of view, a frame configured to align the sensor in frontof a subject's eye, a collimating ring limiting the field of view to adefined region about the center of the eye, and a processor andcomputerized memory configured to measure blood glucose concentration inthe subject by initiating computer implemented instructions. Thecollimating ring defines the distance from the detector to the subject'seye. The processor is configured to store a set of standard controlvalues, where the set of standard control values include a respectiveaverage of control voltage values induced at pixels of the mid-infraredradiation (MIR) sensor for MIR emitted through respective transmissionmedia having known glucose concentrations, store, during a measurementcycle, voltage measurements corresponding to each voltage induced bymid-infrared radiation (MIR) emitted from the eye and incident upon thepixels, integrate the voltage measurements and produce a single voltagevalue for the measurement cycle, calculate an average voltagemeasurement of the single voltage measurements across a plurality ofmeasurement cycles, and correlate the average voltage measurement to theknown blood glucose concentration having a control voltage value equalto the average voltage measurement. Alternatively or additionally, thecollimating ring is made of a material having an emissivity of about 1.

Alternatively or additionally, the apparatus further includes acontinuous medicament delivery device in data communication with theapparatus, configured to receive the blood glucose value from theapparatus, and further configured to deliver insulin to the subject forglucose control.

Another example blood-glucose detection apparatus is described herein.The apparatus includes a mid-infrared (MIR) electromagnetic emissionssensor having a field of view, a frame configured to align the sensor infront of a subject's eye, a collimating ring limiting the field of viewto a defined region about the center of the eye, and a processor andcomputerized memory configured to measure blood glucose concentration inthe subject by initiating computer implemented instructions. Thecollimating ring defines the distance from the detector to the subject'seye. The processor is configured to store a set of standard controlvalues including average control radiance values, for a selectedwavenumber, induced at the pixels for MIR emitted through respectivetransmission media having known glucose concentrations, where thecontrol values are accessible by the processor, receive, in ameasurement cycle utilizing the selected wavenumber, a radiancemeasurement corresponding to MIR incident upon each of the respectivepixels, calculate an average radiance measurement from the respectiveradiance measurements corresponding to respective measurement cycles ina plurality of measurement cycles, and correlate the average radiancemeasurement to the known glucose concentration having a control radiancevalue equal to the average radiance measurement.

Another example method of measuring blood glucose concentration isdescribed herein. The method includes storing a set of standard controlvalues, where the set of standard control values includes a respectiveaverage of control voltage values induced at pixels of a mid-infraredradiation (MIR) sensor for MIR emitted through respective transmissionmedia having known glucose concentrations, storing, during a measurementcycle, voltage measurements corresponding to each voltage induced bymid-infrared radiation (MIR) emitted from the eye and incident upon thepixels, integrating the voltage measurements and producing a singlevoltage value for the measurement cycle, calculating an average voltagemeasurement of the single voltage measurements across a plurality ofmeasurement cycles, and correlating the average voltage measurement tothe known blood glucose concentration having a control voltage valueequal to the average voltage measurement.

Alternatively or additionally, voltages at the pixels are normalized toreference values calculated as reference voltages induced at pixels by ablack body reference emission of MIR.

An example optical glucometer is described herein. The opticalglucometer includes a mid-infrared (MIR) sensor including an array ofpixels connected to a processor that correlates blood glucose values tovoltage readings induced by MIR incident upon the respective pixels, andcomputer memory connected to the processor, the computer memory storinga set of control values including a respective average of controlvoltage values induced at the pixels for MIR emitted through knownglucose concentrations, where the control values are accessible by theprocessor. The processor is configured to receive in a measurement cyclevoltage measurements corresponding to each voltage induced by MIRincident upon the respective pixels, integrate the voltage measurementsand produce a single voltage value for the measurement cycle, calculatean average voltage measurement from the single voltage valuescorresponding to respective measurement cycles in a plurality ofmeasurement cycles, and correlate the average voltage measurement to theknown glucose concentration stored in the memory having a controlvoltage value equal to the average voltage measurement.

Another example optical glucometer is described herein. The opticalglucometer includes an infrared camera including an array of pixelsconnected to a processor that correlates blood glucose values toradiance measurements induced by mid-infrared radiation (MIR) incidentupon the respective pixels, and computer memory connected to theprocessor, the computer memory storing a set of standard control valuesincluding average control radiance values, for a selected wavenumber,induced at the pixels for MIR emitted through respective transmissionmedia having known glucose concentrations, where the control values areaccessible by the processor. The processor is configured to receive, ina measurement cycle utilizing the selected wavenumber, a radiancemeasurement corresponding to MIR incident upon each of the respectivepixels, calculate an average radiance measurement from the respectiveradiance measurements corresponding to respective measurement cycles ina plurality of measurement cycles, and correlate the average radiancemeasurement to the known glucose concentration having a control radiancevalue equal to the average radiance measurement.

In some implementations, the array of pixels is configured to transmit athermal image of an eye to the processor, and the processor isconfigured to convert the thermal image to a grayscale image of radiancevalues.

In some implementations, the processor is configured to receive theradiance measurements for a subset of pixels corresponding to alocalized section of an image of eye and multiply the respectiveradiance measurements for each pixel by a corresponding grayscale imagevalue prior to calculating the average.

In some implementations, radiance values at the pixels are normalized toreference values calculated as reference radiance values induced atpixels by a black body reference emission of MIR.

An example method of measuring blood glucose concentration in eye isdescribed herein. The method includes storing a set of standard controlvalues, where the set of standard control values includes averagecontrol radiance values, for a selected wavenumber, induced at pixels ofa mid-infrared radiation (MIR) sensor for MIR emitted through respectivetransmission media having known glucose concentrations, storing, duringa measurement cycle, radiance measurements corresponding to mid-infraredradiation (MIR) emitted from the eye and incident upon the pixels,calculating an average radiance measurement from the respective radiancemeasurements corresponding to respective measurement cycles in aplurality of measurement cycles, and correlating the average radiancemeasurement to the known blood glucose concentration having an averagecontrol radiance value equal to the average radiance measurement.

In some implementations, the wavenumber is 1030 cm⁻¹ or 1078 cm⁻¹.

In some implementations, the method further includes extracting from athermal image of the pixels the average radiance measurement and atemperature value for a localized area of the pixels.

Other systems, methods, features and/or advantages will be or may becomeapparent to one with skill in the art upon examination of the followingdrawings and detailed description. It is intended that all suchadditional systems, methods, features and/or advantages be includedwithin this description and be protected by the accompanying claims.

The details of one or more embodiments of the invention are set forth inthe accompanying drawings and the description below. Other features,objects, and advantages of the invention will be apparent from thedescription and drawings, and from the claims.

DESCRIPTION OF DRAWINGS

The components in the drawings are not necessarily to scale relative toeach other. Like reference numerals designate corresponding partsthroughout the several views.

FIG. 1 is a thermal image showing spatial resolution of radiance andtemperature responses possible using a mid-infrared (MIR) camera toimage the eye with a spectral region of 8 to 12 microns, centered on 10microns.

FIGS. 2A to 2D are graphs showing voltage (measured by MIR camera) as afunction of glucose (g/300 ml water) for warm solutions of glucose inMIR transparent bags.

FIGS. 3A and 3B are graphs showing glucose concentration (mg/dl) as afunction of voltage (measured by bolometric detector).

FIG. 4 is a thermal image of an eye taken with an MIR camera. The darkring around the eye is used as a reference. The small dots aremeasurement points where pixel values are obtained in three colors. Thetotal value corresponds to MIR energy emitted per pixel.

FIGS. 5A and 5B are graphs showing MIR pixel values as a function ofglucose concentration (mg/dl) from a glucometer for a diabetic (FIG. 5A)and non-diabetic (FIG. 5B).

FIG. 6A is a block diagram of an example optical glucometer having amid-range infrared, MIR, sensor/imaging system for glucose levelmeasurement in the eye surface fluid according to one implementationdescribed herein.

FIG. 6B is a block diagram of an example optical glucometer with a FLIRLEPTON camera or glucose level measurement in the eye surface fluidaccording to one implementation described herein.

FIGS. 6C and 6D illustrates aspects of the example optical glucometershown in FIG. 6B. FIG. 6C shows the shutter upper part. FIG. 6D showsthe shutter lower part.

FIG. 6E is a block diagram of an example computing device.

FIG. 7 is a plot of the sensor responses in the MIR range of a FLIRsensor (FLIR Systems, Inc.). The key feature is that the maximum sensorresponse occurs in the 9 to 10.5 micron range.

FIG. 8 shows the transmittance of glucose over the MIR range (NationalInstitute of Standards and Technology—NIST). Glucose transmits the leastamount of radiation in the 9 to 10 micron range.

FIG. 9 shows the transmittance of water over the MIR range (NISTdatabase). It transmits about 80% of the radiation in the 9 to 10 micronrange

FIG. 10 is a plot of absorbance as a function of wavenumber for twovarying concentrations of glucose in aqueous solution. The spectrum wastaken with the Varian 640-IR FT-IR spectrometer. In the region ofinterest there are two peaks for glucose 1030 cm⁻¹ and 1078 cm⁻¹ (9.7and 9.3 microns (μm), respectively).

FIG. 11 is a plot of the absorbance peak at 1030 cm⁻¹, 9.7 microns (μm)for various concentrations of glucose. The FTIR transmission at thiswavenumber is related to the concentration.

FIG. 12 is a plot of the absorbance peak at 1030 cm⁻¹, 9.7 microns (μm)for glucose concentrations that would be most frequently found for acontrolled diabetic.

FIG. 13 shows bolometer voltage data ratios, taken with respect to ablackbody reference, with blood glucose values using a standardglucometer. There are 30 readings in this data set. The plot is linearas expected and decreases with increasing blood glucose value (BGV)since it is an absorbing film.

FIG. 14 relates radiance data with blood glucose values using the FLIRcamera data. There are 45 readings in this data set. The plot is linearas expected and decreases with increasing BGV since it is an absorbingfilm.

FIG. 15 shows an example MIR camera for use in the disclosed opticalglucometer.

FIG. 16 shows an example optical glucometer with an FLIR camera mountedwith a head support and iris.

FIG. 17 illustrates example operations for detecting blood glucoselevels of a patient according to one implementation described herein.

FIG. 18A shows an image generated using radiance data. FIG. 18B shows animage generated using temperature data. FIG. 18C shows a mask that canbe used to define the pixel region of interest in each of the images.

FIG. 19A illustrates three examples of transmission versus wavenumberover the primary region of interest, wavenumbers 1000 to 1100 cm⁻¹,where glucose absorption is most evident.

FIG. 19B illustrates a plot of all of the FTIR data. The 1000 mg/dlConcentration plot is the lowest line while water is the top most. FIG.19C illustrates the average areas under each curve, around the two peaksin the FTIR spectral data, with the variation in solution concentration.

FIG. 20 illustrates a data set from an apparatus incorporating the FLIRA325sc camera consisting of 103 readings.

FIG. 21 illustrates a plot of noise distribution.

FIG. 22 illustrates the histogram of the noise.

FIGS. 23A (probability density histogram and normal distribution datafit) and 23B (randomly generated data probability density histogram andnormal distribution data fit) show that the noise is basically randomwhich matches what is seen by the observations.

FIG. 24 illustrates the nonlinear correction factor (NLAFunc) as afunction of BGV.

FIG. 25 illustrates radiance versus BGV according to the EyeModel for anextended range, without noise.

FIG. 26 shows experimental data, CharacteristicFunct and EyeModel withnoise plots.

FIG. 27 repeats the plots of FIG. 26 with the number of IR images andhence measurements increased by a factor of 10.

FIG. 28 illustrates a new data set, MeterData, obtained with theEyeModel expression plus randomly generated noise.

FIG. 29 illustrates the results of the MeterData set obtained byEyeModel plus randomly generated noise with 5 smallest DT values shownin the dashed box.

FIG. 30 is a blown up illustration of the 5 smallest DT values shown inFIG. 29.

FIG. 31 illustrates images of a black body reference and a patient's eyecaptured using an apparatus described with respect to FIGS. 6B-6D.

FIG. 32 illustrates a series of 24 images captured using the apparatusdescribed with respect to FIGS. 6B-6D.

FIG. 33 illustrates a plot that shows the expected trend, i.e. thatradiance decreases with increasing BGVs.

FIG. 34 illustrates a plot of eye to black body (BB) radiance referenceratio versus BGV.

FIG. 35 illustrates a plot of eye to black body (BB) radiance referenceratio versus BGV.

FIGS. 36A-36D illustrate an example handheld optical glucometer.

DETAILED DESCRIPTION

Unless defined otherwise, all technical and scientific terms used hereinhave the same meaning as commonly understood by one of ordinary skill inthe art. Methods and materials similar or equivalent to those describedherein can be used in the practice or testing of the present disclosure.As used in the specification, and in the appended claims, the singularforms “a,” “an,” “the” include plural referents unless the contextclearly dictates otherwise. The term “comprising” and variations thereofas used herein is used synonymously with the term “including” andvariations thereof and are open, non-limiting terms. The terms“optional” or “optionally” used herein mean that the subsequentlydescribed feature, event or circumstance may or may not occur, and thatthe description includes instances where said feature, event orcircumstance occurs and instances where it does not. Ranges may beexpressed herein as from “about” one particular value, and/or to “about”another particular value. When such a range is expressed, an aspectincludes from the one particular value and/or to the other particularvalue. Similarly, when values are expressed as approximations, by use ofthe antecedent “about,” it will be understood that the particular valueforms another aspect. It will be further understood that the endpointsof each of the ranges are significant both in relation to the otherendpoint, and independently of the other endpoint.

Disclosed are non-invasive optical means of determining blood glucoselevels in diabetics that can replace the current finger sticktechnology. This would eliminate the need for test strips used withglucometers and would be far less painful. This also cuts the cost ofmonitoring the glucose and would allow for more frequent monitoring ofthe blood glucose level, which is vital for diabetic self-monitoring andcontrol.

Glucose is present in fluid films (tears) on the eyeball surface.Glucose is also present in the eye lens and can cause changes in theshape of the lens. As disclosed herein, the amount of glucose in the eyefluid film can be determined by quantifying mid-infrared (MIR)electromagnetic emissions. Using controlled test solutions, the MIR,centered around 10 microns, was found to be effective for this purpose.

Therefore, in some embodiments, the presence of glucose is indicated byMIR emitted by the eyeball surface. These emissions occur because theeye is warm and radiation is being recorded from a warm blackbodyfiltered by the film that contains the glucose. No laser or light sourceis directed onto the eye to develop/reflect a signal. So this is acompletely passive and non-invasive technology.

In some embodiments, the methods and devices quantify MIR emissions inthe eye at wavelengths from about 8 to 11 μm, including from about 9.6μm to about 11 μm, from about 9.8 to about 10 μm. In someimplementations, the methods and devices quantify MIR emissions in theeye at wavelengths from about 9.7 μm to about 10.3 μm. Additionalwavelengths can be detected; however past 11 microns water absorbs moreIR radiation and therefore reduces signal transmission. Going as low as8 microns also reduces the signal as glucose becomes less absorbing.

In some embodiments, MIR radiation is detected using one or morebolometer-type infrared imaging devices (e.g. microbolometer) measuringvoltage, current, or a combination thereof. In some cases, thebolometer-type infrared imaging device is centered on the 10 micronregion.

For example, Micro-Epsilon of Ortenburg, Germany manufactures aTHERMOMETER CS compact infrared (IR) sensor with integral controller,which has as spectral range of 8 to 14 μm and optional resolution of15:1. The Bolometric sensor can integrate the infrared radiation acrossthe total eye surface and the sensor and amplifier produce a singlevoltage value. In one non-limiting example, these values can be recordedat 100 Hz over a 2 second period. Many recording rates and timeintervals are possible as long as a sufficient number of readings, e.g.,100 readings, are acquired. A sufficiently large sample size improvesthe noise suppression and the average accuracy.

These readings can then be averaged to produce the output. The eye isgenerally located when a few centimeters of the detector lens.

In some embodiments, MIR radiation is detected using a microbolometerinfrared camera. A microbolometer is a specific type of bolometer usedas a detector in a thermal camera. Infrared radiation with wavelengthsbetween 7.5-14 μm strikes the detector material, heating it, and thuschanging its electrical resistance. This resistance change is measuredand processed into temperatures which can be used to create an image.

A microbolometer consists of an array of pixels, each pixel being madeup of several layers. Each company that manufactures microbolometers hastheir own unique procedure for producing them and they even use avariety of different absorbing materials. In some cases, the bottomlayer consists of a silicon substrate and a readout integrated circuit(ROIC). Electrical contacts are deposited and then selectively etchedaway. A reflector, for example, a titanium mirror, is created beneaththe IR absorbing material. Since some light is able to pass through theabsorbing layer, the reflector redirects this light back up to ensurethe greatest possible absorption, hence allowing a stronger signal to beproduced. Next, a sacrificial layer is deposited so that later in theprocess a gap can be created to thermally isolate the IR absorbingmaterial from the ROIC. A layer of absorbing material is then depositedand selectively etched so that the final contacts can be created. Tocreate the final bridge like structure, the sacrificial layer is removedso that the absorbing material is suspended approximately 2 μm above thereadout circuit. Because microbolometers do not undergo any cooling, theabsorbing material must be thermally isolated from the bottom ROIC andthe bridge like structure allows for this to occur. After the array ofpixels is created the microbolometer is encapsulated under a vacuum toincrease the longevity of the device. In some cases the entirefabrication process is done without breaking vacuum.

The quality of images created from microbolometers has continued toincrease. The microbolometer array is commonly found in two sizes,320×240 pixels or less expensive 160×120 pixels. Current technology hasled to the production of devices with 640×480 or 1024×768 pixels. Therehas also been a decrease in the individual pixel dimensions. The pixelsize was typically 45 μm in older devices and has been decreased to 17μm in current devices. As the pixel size is decreased and the number ofpixels per unit area is increased proportionally, an image with higherresolution is created, but with a higher NETD (Noise EquivalentTemperature Difference (differential)) due to smaller pixels being lesssensitive to IR radiation.

The two most commonly used IR radiation detecting materials inmicrobolometers are amorphous silicon (a-Si) and vanadium oxide (VOX).Other materials that have been investigated include: titanium (Ti),yttrium barium copper oxide (YBaCuO), germanium silicon oxide (GeSiO),poly silicon germanium (SiGe), bismuth lanthanum strontium manganeseoxide (BiLaSrMnO), and a protein based cytochrome C and bovine serumalbumin. Amorphous Si (a-Si) works well because it can easily beintegrated into the complementary metal oxide semiconductor (CMOS)fabrication process, is highly stable, a fast time constant, and has along mean time before failure. To create the layered structure andpatterning, the CMOS fabrication process can be used but it requirestemperatures to stay below 200° C. on average. A problem with somepotential materials is that to create the desirable properties theirdeposition temperatures may be too high although this is not a problemfor a-Si thin films. a-Si also possesses excellent values for thermalcoefficient of resistance (TCR), 1/f noise and resistance when thedeposition parameters are optimized.

Vanadium oxide thin films may also be integrated into the CMOSfabrication process although not as easily as a-Si for temperaturereasons. VOX is an older technology than a-Si, and for these reasons itsperformance and longevity are less. Deposition at high temperatures andperforming post-annealing allows for the production of films withsuperior properties although acceptable films can still be madesubsequently fulfilling the temperature requirements. VO₂ has lowresistance but undergoes a metal-insulator phase change near 67° C. andalso has a lower value of TCR. On the other hand, V₂O₅ exhibits highresistance and also high TCR. Many phases of VOX exist although it seemsthat x≈1.8 has become the most popular for microbolometer applications.

Most microbolometers can contain a temperature sensitive resistor whichmakes them a passive electronic device. In some cases, themicrobolometers use a thin film transistor (TFT), which is a specialkind of field effect transistor. The main change in these devices wouldbe the addition of a gate electrode. Although the main concepts of thedevices are similar, using this design allows for the advantages of theTFT to be utilized. Some benefits include tuning of the resistance andactivation energy and the reduction of periodic noise patterns. As of2004 this device was still being tested and was not used in commercialIR imaging.

For example, FLIR Systems, Inc. of Wilsonville, Oreg. manufactures anuncooled microbolometer infrared camera (FLIR A325sc) with a 320×240long wavelength (LWIR) resolution and a spectral range of 7.5 to 13.0μm. In these embodiments, the infrared camera has a lens that allows oneto focus more directly on the eye and the reference ring. In some cases,a rectangular region of an infrared sensor is positioned to cover theeye such that the eye is properly within the infrared camera field ofview. This can, for example, include about 400 pixels, e.g., about 10 by40 pixels. This can be used to obtain the average radiance values. Theregion of the infrared sensor dedicated to imaging an eyeball may varyin size and shape as necessary for patient anatomy, ambient lighting,sample sizes, and camera parameters typically adjusted for testconditions. In this regard, the set of pixels sensitive to the eye maybe circular, elliptical, or other convenient shapes that allow for datacollection under the circumstances at hand. As shown in FIG. 4, thesensor gathers sufficient image data to provide a desirable number ofradiance and/or temperature readings from select positions on and aroundthe eye, particularly in the center of the eye. The number of readingsshown in FIG. 4 is not limiting of the readings available for analysis,and in one non-limiting example, at least 50 readings may be gatheredacross the center of the surface of the eye and the optical filmthereon. Tracking the region from which radiance and temperaturereadings have been gathered is, furthermore, useful in creating asoftware mask for acquiring normalized data readings across the sensor,thereby receiving the necessary temperature and radiance data.

Infrared imaging has a much higher spatial resolution. It offersenhanced temperature resolution as well, which is not provided by thebolometer. It can also output data as red/green/blue images along withdata files from the image presented in terms of radiance data(Watts/square cm per steradian) and temperatures, degrees Celsius, foreach pixel. This camera was used to confirm bolometric observations andto search for strategies to determine the glucose values from the eye.Eye temperatures vary but the glucose solution appears to be uniformacross the eye.

Infrared imaging can be used instead of, or as a confirmation of,bolometric data. Infrared imaging also allows for detection of glucosedistribution across the eye surface. Infrared imaging is more sensitivebut the bolometer is sensitive enough and may be cheaper and lesscomplicated in a medical device.

In some embodiments, the device quantifies pixel values representing MIRemissions at a plurality of pre-determined or random points in the eye.In some cases, the device measures pixel values across the entire imageof the lens, or some subset thereof (also referred to herein as a “pixelregion of interest”).

Referring now to FIG. 6A, a block diagram of an example opticalglucometer having a MIR sensor/imaging system for glucose levelmeasurement in the eye surface fluid is shown. The optical glucometercan include a thermographic imaging device 102 configured to capture MIRelectromagnetic emissions. The thermographic imaging device 102 can beused to capture one or more images of a subject's eye 104. For example,the thermographic imaging device 102 can be an infrared camera such as abolometric-type or microbolometric-type device as described herein. Asshown in FIG. 6A, the thermographic imaging device 102 can include a MIRsensor and data acquisition hardware/software (e.g., microprocessor,analog-to-digital converter, filters, amplifiers, etc.). As describedherein, the MIR sensor can be configured for peak sensitivity atwavelengths in a range from about 9 μm to about 11 μm. In someimplementations, the MIR sensor can be configured for peak sensitivityat wavelengths in a range from about 9.7 μm to about 10.3 μm. This canbe accomplished using the native detector sensitivity of a MIR sensorand/or with hardware/software. These wavelength ranges overlap with 9-10μm where glucose in the eye film acts as a filter that inhibits thetransmission of light. Glucose inhibits transmission of IR light withpeaks of specific interest at 9.7 and 10.3 μm. It should be understoodthat the MIR sensor can be configured for peak sensitivity atwavelengths in ranges other than those provided above as examples.

Bolometers and microbolometers are known in the art. Bolometers include,but are not limited to, the FLIR A325sc thermal imaging camera from FLIRSystems, Inc. of Wilsonville, Oreg., which is provided only as anexample. Microbolometers include, but are not limited to, the FLIRLEPTON thermal imaging camera from FLIR Systems, Inc. of Wilsonville,Oreg., which is provided only as an example. The FLIR LEPTON camera is aLWIR camera with a relatively small IR camera (i.e., smaller than adime) as compared to a bolometer and can be incorporated into handheldelectronic devices such a smartphone or tablet or optical glucometer.The FLIR LEPTON camera uses a focal plane array of 160×120 or 80×60active pixels, which facilitates incorporation into a handheld device.Although the FLIR LEPTON camera is configured for uncooled thermalimaging, this disclosure contemplates that the images can be calibratedusing a black body reference as described in Example 3. It should beunderstood that the FLIR A325sc and LEPTON cameras are only provided asexample bolometers and microbolometers, respectively. This disclosurecontemplates using other bolometers and/or microbolometers than thoseprovided as examples. For example, in some implementations, amicrobolometer with a focal plane array of about 100×100 pixels can beused. With this type of resolution, it is possible to achieve sufficientsignal-to-noise enhancement. The optical glucometer can also include acomputing device 106. For example, the computing device 106 can be theexample computing device as described with regard to FIG. 6E. Thethermographic imaging device 102 and the computing device 106 can becommunicatively coupled, for example, by one or more communicationlinks. This disclosure contemplates the communication links are anysuitable communication link. For example, a communication link may beimplemented by any medium that facilitates data exchange between thethermographic imaging device 102 and the computing device 106 including,but not limited to, wired, wireless and optical links. Examplecommunication links include, but are not limited to, an internal databus, a LAN, a WAN, a MAN, Ethernet, the Internet, or any other wired orwireless link such as WiFi, WiMax, 3G or 4G

It should be appreciated that the logical operations described hereinwith respect to the various figures may be implemented (1) as a sequenceof computer implemented acts or program modules (i.e., software) runningon a computing device (e.g., the computing device described in FIG. 6E),(2) as interconnected machine logic circuits or circuit modules (i.e.,hardware) within the computing device and/or (3) a combination ofsoftware and hardware of the computing device. Thus, the logicaloperations discussed herein are not limited to any specific combinationof hardware and software. The implementation is a matter of choicedependent on the performance and other requirements of the computingdevice. Accordingly, the logical operations described herein arereferred to variously as operations, structural devices, acts, ormodules. These operations, structural devices, acts and modules may beimplemented in software, in firmware, in special purpose digital logic,and any combination thereof. It should also be appreciated that more orfewer operations may be performed than shown in the figures anddescribed herein. These operations may also be performed in a differentorder than those described herein.

Referring to FIG. 6E, an example computing device 600 upon whichembodiments of the invention may be implemented is illustrated. Itshould be understood that the example computing device 600 is only oneexample of a suitable computing environment upon which embodiments ofthe invention may be implemented. Optionally, the computing device 600can be a well-known computing system including, but not limited to,personal computers, servers, handheld or laptop devices, multiprocessorsystems, microprocessor-based systems, network personal computers (PCs),minicomputers, mainframe computers, embedded systems, and/or distributedcomputing environments including a plurality of any of the above systemsor devices. Distributed computing environments enable remote computingdevices, which are connected to a communication network or other datatransmission medium, to perform various tasks. In the distributedcomputing environment, the program modules, applications, and other datamay be stored on local and/or remote computer storage media.

In its most basic configuration, computing device 600 typically includesat least one processing unit 606 and system memory 604. Depending on theexact configuration and type of computing device, system memory 604 maybe volatile (such as random access memory (RAM)), non-volatile (such asread-only memory (ROM), flash memory, etc.), or some combination of thetwo. This most basic configuration is illustrated in FIG. 6E by dashedline 602. The processing unit 606 may be a standard programmableprocessor that performs arithmetic and logic operations necessary foroperation of the computing device 600. The computing device 600 may alsoinclude a bus or other communication mechanism for communicatinginformation among various components of the computing device 600.

Computing device 600 may have additional features/functionality. Forexample, computing device 600 may include additional storage such asremovable storage 608 and non-removable storage 610 including, but notlimited to, magnetic or optical disks or tapes. Computing device 600 mayalso contain network connection(s) 616 that allow the device tocommunicate with other devices. Computing device 600 may also have inputdevice(s) 614 such as a keyboard, mouse, touch screen, etc. Outputdevice(s) 612 such as a display, speakers, printer, etc. may also beincluded. The additional devices may be connected to the bus in order tofacilitate communication of data among the components of the computingdevice 600. All these devices are well known in the art and need not bediscussed at length here.

The processing unit 606 may be configured to execute program codeencoded in tangible, computer-readable media. Tangible,computer-readable media refers to any media that is capable of providingdata that causes the computing device 600 (i.e., a machine) to operatein a particular fashion. Various computer-readable media may be utilizedto provide instructions to the processing unit 606 for execution.Example tangible, computer-readable media may include, but is notlimited to, volatile media, non-volatile media, removable media andnon-removable media implemented in any method or technology for storageof information such as computer readable instructions, data structures,program modules or other data. System memory 604, removable storage 608,and non-removable storage 610 are all examples of tangible, computerstorage media. Example tangible, computer-readable recording mediainclude, but are not limited to, an integrated circuit (e.g.,field-programmable gate array or application-specific IC), a hard disk,an optical disk, a magneto-optical disk, a floppy disk, a magnetic tape,a holographic storage medium, a solid-state device, RAM, ROM,electrically erasable program read-only memory (EEPROM), flash memory orother memory technology, CD-ROM, digital versatile disks (DVD) or otheroptical storage, magnetic cassettes, magnetic tape, magnetic diskstorage or other magnetic storage devices.

In an example implementation, the processing unit 606 may executeprogram code stored in the system memory 604. For example, the bus maycarry data to the system memory 604, from which the processing unit 606receives and executes instructions. The data received by the systemmemory 604 may optionally be stored on the removable storage 608 or thenon-removable storage 610 before or after execution by the processingunit 606.

It should be understood that the various techniques described herein maybe implemented in connection with hardware or software or, whereappropriate, with a combination thereof. Thus, the methods andapparatuses of the presently disclosed subject matter, or certainaspects or portions thereof, may take the form of program code (i.e.,instructions) embodied in tangible media, such as floppy diskettes,CD-ROMs, hard drives, or any other machine-readable storage mediumwherein, when the program code is loaded into and executed by a machine,such as a computing device, the machine becomes an apparatus forpracticing the presently disclosed subject matter. In the case ofprogram code execution on programmable computers, the computing devicegenerally includes a processor, a storage medium readable by theprocessor (including volatile and non-volatile memory and/or storageelements), at least one input device, and at least one output device.One or more programs may implement or utilize the processes described inconnection with the presently disclosed subject matter, e.g., throughthe use of an application programming interface (API), reusablecontrols, or the like. Such programs may be implemented in a high levelprocedural or object-oriented programming language to communicate with acomputer system. However, the program(s) can be implemented in assemblyor machine language, if desired. In any case, the language may be acompiled or interpreted language and it may be combined with hardwareimplementations.

Referring now to FIG. 17, a flow diagram illustrating example operationsfor detecting glucose levels in a subject is shown. As described herein,the infrared radiation emitted by the human eye and filtered by glucosein the eye fluid film can be detected and correlated with standardfinger stick blood glucose values, BGV. This disclosure contemplatesthat the operations can be implemented using the example opticalglucometer (e.g., a patient self-monitoring system) described withrespect to FIG. 6A or FIG. 6B, for example. At 1702, a plurality ofimages of the subject's eye can be captured using a thermographicimaging device (e.g., thermographic imaging device 102 of FIG. 6A or IRcamera 655 of FIG. 6B). This disclosure contemplates capturing aplurality of images to reduce noise. For example, in someimplementations, four images can be captured. Although four images isprovided as an example, this disclosure contemplates capturing more orless than four images. It should be understood that there are tradeoffsbetween noise reduction and processing/storage requirements with anincreasing number of images. The images can be transmitted from thethermographic imaging device to a computing device (e.g., computingdevice 600 of FIG. 6E) over a communication link for further processing.

At 1704, an average radiance value for a pixel region of interest can becalculated using the plurality images of the subject's eye. The pixelregion of interest can optionally be a region of the infrared sensorpositioned to cover a region of the subject's eye within a field of viewof the thermographic imaging device. As described herein, the pixelregion interest can have various sizes and/or shapes (e.g., circular,elliptical, or other convenient shapes), for example, tailored asnecessary for patient anatomy, ambient lighting, sample sizes, and/orcamera parameters. In an example implementation, the pixel region ofinterest can include 400 pixels, e.g., about 10 by 40 pixels, which isprovided only as an example. This disclosure contemplates a pixel regionof interest more or less than 400 pixels. To calculate the averageradiance value for the pixel region of interest, a respective averageradiance value for the pixels in each of the plurality of images can becalculated. This can be accomplished, for each image, by integrating therespective radiance value for each of the pixels in the pixel region ofinterest to obtain a single radiance value. The single average radiancevalue for each of the images can then be averaged to obtain the averageradiance value for the pixel region of interest (i.e., a single averageradiance value across all images).

At 1706, the average radiance value for the pixel region of interest canbe corrected based on a temperature of the subject's eye at the time ofimage capture. As described below in Example 3, the average radiancevalue for the pixel region of interest can be scaled to a correspondingradiance value at about 33.5° C. This correction can compensate for thewavelength dependent response of the IR sensor of the thermographicimaging device.

At 1708, the corrected average radiance value for the pixel region ofinterest can be correlated to a blood glucose value of the subject. Asdescribed herein, the blood glucose value of the subject can be obtainedby database lookup. Optionally, as described below in Example 3, asearch algorithm can be used to identify a most probable blood glucosevalue of the subject corresponding to the corrected average radiancevalue for the pixel region of interest.

EXAMPLES Example 1

Measurements were obtained using three IR sensor types. Two arebolometric-type devices, one measuring voltage and the other current,sensitive in the 8 to 12 micron regions and recording all radiation witha maximum sensitivity around 10 microns. These collected all of the MIRradiation along with the glucose signature. They were sensitive enoughto observe changes in glucose levels, as indicated below. The opticalconfiguration was such that the total eye was included in theradiation-collecting field.

The third device was an MIR camera that had high spatial resolution andhence point-by-point readings across the eye were possible. The spectralregion was again 8 to 12 microns centered on 10 microns.

FIG. 1 illustrates the spatial resolution possible using an MIR camera.The dark disk is the reference for image-to-image comparison.

A large volume of warm solution in an MIR transparent bag was used tocompare infrared radiation with concentrations. These solutions were notfilms, but rather bulk samples. FIGS. 2A to 2D illustrate the trends anddemonstrate that there is a strong relationship between concentrationand MIR signal detected using a bolometric detector.

In FIGS. 2A to 2D, the vertical axis is in volts while the horizontalaxis is in grams of glucose powder dissolved into 300 ml of water.Glucometers measure in milligrams per deciliter so this is a wide range.FIG. 2C covers the region over which a diabetic might expect to seetheir glucose values, i.e. ranging from about 67 to 300 mg/dL. FIG. 2Dshows a more refined scale range from 16, a very low values for apatient, to 100 mg/dL.

FIGS. 3A and 3B show glucometer values in mg/dL on the vertical axis andthe horizontal axis is in detector voltage values using a bolometricdetector. FIG. 3A is a single day's data and FIG. 3B is a combination ofmultiple days' readings calibrated to a set standard value.

FIG. 4 is an image of an eye using an MIR camera. Spectral selection wasdue to camera response max centered on 10 micron region. The dark ringaround the eye was used as a reference. The small dots seen in the imageare measurement points were pixel values are obtain in three colors. Thetotal value corresponds to the MIR energy emitted per pixel.

The averages over the eye values were normalized to the reference ring.FIGS. 5A and 5B are plots of MIR grayscale pixel values versusglucometer readings for a diabetic (FIG. 5A) and non-diabetic (FIG. 5B).Not only was there a strong correlation between grayscale pixel valuesand glucometer readings but also the sensitivity is sufficient such thatone can distinguish between readings of 125 and 129 mg/dL (FIG. 5A).FIGS. 5A and 5B utilize a pixel value scale related to photon countsthat the sensor of a sensor reads. These are correlated with theradiance or temperature via algorithms programmed via computer readablememory and a corresponding processor in the apparatus, e.g., pixelvalues based on grayscale intensity in terms of photon counts or energy.The gray scale images remove Red Green Blue color value effects. It isthese grayscale values, which may be expressed as multi-bit intensityvalues, indexed intensity values, or on a logarithmic scale for photonemissions, that are then matched to radiance and temperaturecorrelations via software stored in the apparatus described herein.

As shown in FIG. 5B, a strong correlation exists between grayscale pixelvalues and glucometer readings as before. Again sensitivity is good,i.e. 97 and 102 mg/dL are easily distinguished.

Therefore, there is a strong correlation between MIR values measured ineye fluid films and blood glucose levels. This opens the door to a newclass of medical devices that can be effectively used in diabeticself-monitoring.

Example 2

FIG. 7 is a plot of sensor responses in the MIR range provided by anexample manufacturer (i.e., FLIR Systems, Inc.). The key feature is thatthe maximum sensor response occurs in the 9 to 10.5 micron range. Itshould be understood that, although this is FLIR camera data, thebolometer has a similar response.

FIG. 8 shows the transmittance of glucose over the MIR range (figureobtained from the National Institute of Standards and Technology—NIST).Glucose transmits the least amount of radiation in the 9 to 10 micronrange. This curve is an excellent approximation to a glucose and watersolution.

FIG. 9 shows the transmittance of water over the MIR range (NISTdatabase). It transmits about 80% of the radiation in the 9 to 10 micronrange.

From the plots shown in FIGS. 7-9, it can be seen that these detectors,combined with the transmittance of glucose and water, indicate that themaximum effect of a glucose solution in the eye fluid would occur in thespectral range where the sensors sensitivity is optimized, i.e. 9 to 10microns.

This is the best spectral range to detect glucose. This work issummarized in a study of the application of Fourier Transform-IRSpectroscopy. In clinical examples for the control groups of FIGS.10-12, a Fourier Transform analysis of infrared image pixel values(FT-IR) was conducted for attenuated total reflectance (ATR) datagathered for control solutions. While in vivo testing of a subject's eyemeasures mid-range infrared emissions from an eyeball, without directedinfrared radiation from the camera to the eye, the ATR analysis of thecontrol samples utilizes the ATR method of directing infrared radiationat the sample and measuring reflected radiation back onto the sensor.For FIGS. 10-12, ATR FT-IR Spectroscopy was used to measure theconcentration of glucose in aqueous samples including ones mixed withartificial tears to mimic the composition of the intraocular fluid. Thevibrational modes of glucose in the region, 980-1200 cm⁻¹, wereexploited as identifiers of the concentration of the glucose. Thetransmission, at the two peaks (1030 cm⁻¹ and 1078 cm⁻¹) chosen foranalysis, is proportional to the concentration of the glucose in thesample. At concentrations above 90 mg/dL this method appears to be avalid technique to measure the concentration of glucose in aqueoussolutions with a sensitivity of 20 mg/dL.

As seen in FIGS. 10-12, the transmission value (and the associatedabsorbance) varies for the glucose peaks at various concentrations ofwater. This is true for control specimens having glucose in both waterand in water mixed with the artificial tears. When the absorbance isplotted as a function of concentration at higher concentrations (90-1000mg/dL), there is a linear relationship which occurs regardless of thepeak, 1030 or 1078 cm⁻¹, analyzed (see FIG. 10). At lower concentrationsof glucose (50-90 mg/dL), however, the plot is no longer linear. Thelinear fit at the higher concentrations is reproducible. Differences of20 mg/dL glucose concentrations are detectable using this method.

FIG. 10 shows the results of a control test that plots absorbance as afunction of wavenumber for two varying concentrations of glucose inaqueous solution. The spectrum was taken with the Varian 640-IR FT-IRspectrometer. In the region of interest there are two peaks for glucose1030 cm⁻¹ and 1078 cm⁻¹ (9.7 and 9.3 microns, respectively).

Various glucose concentration standards were created and the spectrawere taken. FIG. 11 is a control plot of the various concentrations andthe absorbance peak at the wavenumber of 1030 cm⁻¹ and wavelength at 9.7microns. The FTIR transmission at this wavenumber is related to theconcentration.

FIG. 12 is like FIG. 11 but concentrating on the lower glucoseconcentrations. This is the region where the glucose values would bemost frequently found for a controlled diabetic.

The Bolometric Sensor

In the case of the Micro-Epsilon sensor, the device can be fixed in amounting stand so the test subject can move their eye to approximately 2cm from the sensor. There can be head and eye supports so that motion islimited. While looking directly at the sensor, lens and data can becollected for 2 seconds. This can generate 200 readings, which are thenaveraged automatically by the data acquisition system. Immediately afterthe eye reading a blackbody is placed before detector at the sameposition of the eye in the previous test and the measures are repeatedto provide blackbody reference values. The difference between thebolometer eye values and the blackbody reference (BB) values, ΔV, istaken as “the data” for correlation with blood glucose values (BGVs).The averages are taken as ΔV/BB to be correlated to BGV.

The bolometric sensor is generally inexpensive. A medical monitoringdevice based on this class of sensor should be easy to develop. Thistype of sensor is also generally less sensitive than one similar to thefull IR camera would be.

FIG. 13 relates bolometer voltage data ratios, taken with respect to ablackbody reference, with blood glucose values using a standardglucometer. There are 30 readings in this data set. Again the plot islinear as expected and decreases with increasing BGV since it is anabsorbing film.

The data spread is primarily due to eye temperature. Otherwise there israndom noise in the signal. The data in this plot has been noisefiltered before presentation. The central line is the linear fit and thetwo side-lines represent plus/minus one standard deviation.

The FLIR Camera

The FLIR camera is more sensitive and provides radiance data as well astemperature values. For this reason, it was used for the basicfeasibility studies.

Procedure:

First an infrared (IR) image of the eye can be made that is displayed ina multi-color format. Once again, the head and eye placement can berestricted by a head-rest and an optical iris. These maintain the sameconfiguration each time. It is the radiance data that is the mostvaluable. The following shows how this data is isolated for specific eyeregions.

An iris can be used to hold the relative position between the camera andthe test subject's eye. It also can provide a reference for thetemperature and radiance data field.

At the same time that this image is acquired the camera can produce afile of radiance and a temperature data per pixel that matches the colorimage.

These files can be presented as gray scale images. Since it is difficultto find regions in the eye from a gray scale radiance data image, themulti-colored image can be used to create a mask that localizes eacharea of interest within in the eye:

The areas of interest are in some cases the left and right corners andcenter of the eye. The highest eye temperatures are generally in theright corner (near the nose) followed by the left then the center. Thereis about a 2 degree C. variation between these values.

The mask and gray scale radiance image can then be multiplied togetherto form another image of radiance data isolated within the areas ofinterest.

The radiance data can then be averaged over each region to provideinformation such as:

{127, 0.00428962, 0.00428217, 0.004344389}

127 is a BGV added for the purpose of illustration and 0.00428962 is inWatts/cm2-strd

Using this same procedure a temperature value, degrees C. below, can beobtained for each area:

{127, 0.00428962, 0.00428217, 0.00434438, 33.6500, 33.3320, 34.3795}

Results:

FIG. 14 relates radiance data with blood glucose values using the FLIRcamera data. There are 45 readings in this data set. The plot is linearas expected and decreases with increasing BGV since it is an absorbingfilm.

The data spread is primarily due to eye temperature. Otherwise there israndom noise in the signal. The data in this plot has been noisefiltered before presentation. The central line is the linear fit and thetwo side-lines represent plus/minus one standard deviation.

Since there are temperature variations within the eye and betweentesting sessions, models were developed that can be used to makeadjustments for these variations. These are based on ideal blackbodies,the camera response and water attenuation of the signal. These would bepart of system's data analyses software.

Another issue is day to day tracking of readings. This is addressed byreferencing all readings to a standard, i.e. blackbody values or controlglucose solutions.

Embodiments of an optical glucometer as disclosed herein may beconsidered in terms of methods and apparatuses using the correlationbetween Mill induced voltages and blood glucose values as previouslydescribed. The physical correlation between optical glucoseconcentrations and voltage responses in the disclosed hardware for abolometer allow for methods and apparatuses that conveniently provideblood glucose values for a subject. In another example, the physicalcorrelation between radiance emissions from a subject's eye and anassociated thermal image analysis, taken at a given wave number,provides similar blood glucose evaluation.

Considering a bolometer embodiment first, in one embodiment, a bolometermay be used to perform a method of determining blood glucoseconcentration in optical fluid, e.g., tears forming fluid films on aneyeball surface. The method incorporates measuring a subject's (human orother animal) blood glucose concentration by measuring the glucoseconcentration in the tears on the eyeball. These measurements occur invivo with real time data analysis.

The method of measuring blood glucose concentration in a fluid film onan eyeball of a subject includes having a set of standard control valuesfor known glucose concentrations in place, such as control valuesdetermined by the control test results of FIGS. 2A-2D and FIGS. 3A and3B. Tabulating a set of standard control values for known glucoseconcentrations may include determining and storing a respective averageof control voltage values induced at pixels of a mid-infrared radiation(MIR) sensor for MIR emitted through respective transmission mediahaving known glucose concentrations. The method incorporates the use ofa pixel by pixel analysis of voltages induced at each respective pixelby MIR incident on an array of pixels in a bolometer. In one aspect, ameasurement cycle for blood glucose concentration includes collectingall necessary voltage measurements at each relevant pixel in an array ofMIR sensitive pixels and storing, during the measurement cycle, voltagemeasurements corresponding to each voltage induced by mid-infraredradiation (MIR) emitted from the eye and incident upon the relevantpixels. One goal of the method is to identify a highly accurate averagevoltage measurement that can be correlated to control voltages, such asthose set forth in FIGS. 2A-3B, and determine a subject's glucoseconcentration in the eye fluid. In one non-limiting analysis, thebolometer processes several measurement cycles, and for each measurementcycle, includes integrating the set of voltage measurements collected ateach pixel in the sensor array to produce a single voltage value for therespective measurement cycle. Using a single voltage measurementdetermined from the array of pixels for each measurement cycle, themethod includes calculating an average voltage measurement of the singlevoltage measurements across a plurality of measurement cycles. Theaverage voltage measurement can then be used to determine acorresponding blood glucose concentration by selecting a known bloodglucose concentration having a control voltage value equal to theaverage voltage measurement. The blackbody reference voltages induced asshown in FIG. 4 provide the necessary scaling for accuracy purposes.

In one embodiment, the bolometer is configured to induce voltages atpixels in a sensor having an array of pixels such that the voltages areinduced for MIR having a wavelength of about 8 to 11 microns. Anotherembodiment includes inducing voltage at the pixels for MIR incident uponthe pixels having a wavelength of about 10 microns. These wavelengthdeterminations can be accomplished by either a lens configuration in thebolometer directing the MIR of particular wavelength to the array ofpixels or in the materials used to form the pixels such that voltagesare induced for particularly selected wavelengths. Accordingly, thewavelength of MIR directed to a sensor may be tuned to the properwavelength for glucose analysis as set forth in the above discussions.

The method noted above may be implemented in an optical glucometerhaving a mid-infrared (MIR) sensor comprising an array of pixelsconnected to a processor that correlates blood glucose values to voltagereadings induced by MIR incident upon the respective pixels. A computermemory is connected to the processor, the computer memory storing a setof the control values described above as including a respective averageof control voltage values induced at the pixels for MIR emitted throughknown glucose concentrations. The glucometer is configured such that thecontrol values are accessible by the processor. In one non-limitingexample of data analysis, the processor may be configured with computerimplemented instructions, or software, stored in computer readable mediasuch that the processor receives, in a single measurement cycle, voltagemeasurements corresponding to each voltage induced by MIR incident uponrespective pixels in an array of pixels. The processor integrates thevoltage measurements and produces a single voltage value for themeasurement cycle. With this single voltage measurement for multiplemeasurement cycles, the processor has sufficient data to calculate anaverage voltage measurement from the single voltage values correspondingto respective measurement cycles in a plurality of measurement cycles.The processor then correlates the average voltage measurement to a knownglucose concentration stored in the memory by selecting a known glucoseconcentration having a control voltage value equal to the averagevoltage measurement.

In a different embodiment, the method of determining blood glucoseconcentration by analyzing optical fluid over a subject's eye may beimplemented using a thermal image from an infrared camera. An infraredcamera also has a pixel array connected to a processor that correlatesblood glucose values to radiance measurements induced by mid-infraredradiation (MIR) incident upon the respective pixels. The processor andpixel array are connected to computer memory storing a set of standardcontrol values. The standard control values include average controlradiance values, for a selected wavenumber, induced at the pixels fromMIR emitted through respective transmission media having known glucoseconcentrations. The control values are accessible by the processor tocorrelate an average radiance measurement from a thermal image to aknown glucose concentration that has the same radiance value undercontrol conditions. The infrared camera is configured to create athermal image of a subject's eye, or portion thereof, and receive at theprocessor a radiance measurement corresponding to MIR incident upon eachof the respective pixels within the camera sensor array. The camerasensor may be tuned, via lenses or the materials of the sensor itself,to produce a thermal image at a particular wave number for a givenmeasurement cycle. The camera is configured to repeat the measurementsover several thermal images and calculates an average radiancemeasurement over a plurality of thermal images. The average radiancemeasurement is correlated to a known glucose concentration having acontrol radiance value equal to the average radiance measurement.

As shown in FIG. 10, glucose concentrations are most readily detected inthermal images from cameras at wave numbers of 1030 cm-1 or 1078 cm-1.Using one of these wave numbers in camera set up, the thermal images areadapted for implementing the method of correlating radiance measurementsto control radiance values as described.

Embodiments of a glucometer as described herein may incorporate hardwareand software that allows for a glucometer to gather the data points atthe location of the subject's eye and transmit the data to a remoteserver for data processing and results. To implement this embodiment,the glucometer may be a handheld device that encompasses a transceiverfor wireless communications across a network, such as the internet. Theglucometer may also have physical dimensions providing an appropriatewave number for glucose analysis as set forth herein. In one embodiment,the glucometer incorporates a collimating ring that not only determinesthe distance of the sensor from the subject's eye, but also providesreference data in a collected image. The collimating ring may be made ofa material with an emissivity of about 1. In one example, thetemperature of the collimating ring is held to a range of about 33degrees Celsius to about 35 degrees Celsius, more particularly either 33degrees Celsius or 34 degrees Celsius and resulting radiance values areused for calibration.

Example 3

In order to provide a system for patient self-monitoring, a more compactversion of the system as compared to the system incorporating the FLIRcamera (e.g., FLIR A325sc camera) is described below. Such a system canincorporate a relatively smaller thermographic imaging device such asthe FLIR LEPTON camera to serve as the IR sensor and that can performthe same glucose detection as the FLIR camera.

The FLIR LEPTON camera has the same type of IR sensing chip, VOXmicro-bolometer, that the more advanced FLIR A325sc uses but withoutcooling. Also, although it does deliver a red green blue (RBG) image, itis not supported by extensive analysis software within the camera. Thisdisclosure contemplates that sensitivity could be improved, if needed,by cooling using a Peltier based devices. Also, a simplified dataanalysis system is needed to make interpretation of the readings. Thenecessary software for image acquisition and analyses, as well as ameans to use this to make predictions of the patients BGV, have beendeveloped as described below. The methodology and related devicesrevolve around the detection of the radiation and then theidentification of the appropriate signals.

Data Acquisition

The following is the procedure for use of the FLIR A325sc camera tomeasure blood glucose, BGV, in the eye. The method is the same for adetection system based on the FLIR LEPTON camera as for a detectionsystem based on the FLIR A325sc.

The patient looks directly into the camera at a distance of about 0.1 mwhile the camera records an image of eye and saves the image as CSVfiles. It should be understood that the data format (i.e., CSV file) isprovided only as an example and that other data formats can be used.This process is repeated a plurality of times (e.g., 4 times) in rapidsuccession and the resulting data is averaged.

Two sets of data are taken to allow for corrections due to temperaturefluctuations. One of the CSV files has radiance data (Watts/cm²-Sr) perpixel and the other file has temperature data ° C. These two filesconstitute the core of the data readings that are made to determine theglucose level in the eye. FIG. 18A shows an image generated usingradiance data. FIG. 18B shows an image generated using temperature data.FIG. 18C shows a mask that can be used to define the pixel region ofinterest in each of the images. In FIG. 18C, the mask is rectangular inshape and corresponds to a central region of the eye. As describedherein, the size, shape, and/or location of the mask is not limited tothe example in FIG. 18C. The mask ensures that the same area is comparedwithin the eye images whether they be radiance or temperature fielddata. The masked image is then cropped to remove theradiance/temperature data field of interest as shown below.

This cropped image is a {17,33} pixel value field, 561 elements, withtypical data of the form:

{0.00430927, 0.00431093, 0.00430939, 0.00430872, 0.00430759, \

0.00430621, 0.0043061, 0.0043072, 0.00430605, 0.00430715, 0.00430791, \

0.0043081, 0.0043076, 0.00431006, 0.00431159, 0.00431252, 0.00431627, \

0.00431841, 0.00432107, 0.00432293, 0.00432496, 0.00432592, \

0.00432877, 0.00432923, 0.00433073, 0.00433161, 0.00433528, \

0.00433538, 0.00433793, 0.00433763, 0.00434009, 0.0043405, 0.00434075}

The field average is 0.00431981 Watts/cm²-Sr.

In the same manner, the average temperature field over this region isobtained, in this case it is 33.9346 C.

The data sets are composed of three numbers; one is the blood glucosevalue, (from direct glucometer blood measurements), the radiance, andthe temperature of the eye. The data format is {BGV, Radiance,Temperature C}. In this case, the set is:

-   -   {157, 0.00431981, 33.9346}

It has been found that in general the eye temperature is nearly constantat roughly 33.5° C. Since the eye acts as a blackbody emitting throughthe eye fluid film, which is basically a filter, the glucose absorbs theradiation from the eye. The nearly constant temperature makes itpossible for an observer to discern the values of the blood glucose inthe eye film from the background radiation. When there are significanttemperature variations (e.g., +/−one degree or more) betweenmeasurements it is necessary to perform a temperature scaling, orcorrection, TC, to the radiance values so that all the data matches33.5° C.

The temperature correction method is based on a temperature dependentfunction. The temperature dependent function is device specific and canbe developed for a particular thermographic imaging device by using astandard blackbody and direct measurements of the radiance from theblack body cavity. This provides a correlation between actual black bodytemperature and the radiance emitted by the black body as recorded bythe thermographic imaging device. This takes into consideration thewavelength dependent response of the detector that is used in thethermographic imaging device (e.g., a FLIR A 325sc or FLIR LEPTONcamera). The region in which the camera is most sensitive, the 8 to 14μm range, yields a radiance versus as a function of temperature that islinear. The function that is derived from the method outlined above is71% of a theoretical blackbody emitting over the same region at thecorresponding temperatures;

-   -   DatafitBB[Tp]=0.002139894400283821′+0.00006380427549443183′ Tp

The correction is then given by:

RadianceTC=(Radiance Measured)*(DatafitBB[33.5]/DatafitBB[Tmeasured].

For this data set the corrections lead to the data elements {157,0.00429228, 33.5}, where the radiance value is 99.4% of its test value.

Following the procedure outlined above, larger data sets have beenobtained and employed in the development of the analytical means for BGVdetection. The data sets obtained by this experimental method is patientdependent and can be generalized by acquiring data from a very largegroup of people over an extended time frame. This work has indicatedthat models can be developed that can allow generation of a “training”data set that can be used in a detection system. These models aredescribed further below.

IR Transmission Through Solutions

It has been shown that an aqueous solution of glucose does in factstrongly absorb radiation in the 8 to 14-micron spectral region and thatthe absorption increases as the glucose concentration increases. Thetransmission of radiation through the glucose rather than the absorptionhas been examined, since this best describes the filter effect.

The initial testing to confirm this was done by using a Fouriertransform infrared spectrometer, Varian 640 FTIR. In these tests 10 μLsolutions were placed in the spectrometer's ATR cell and thetransmittance was measured across the spectrum for each solution. Theconcentrations range from roughly 50 to 2000 mg/dL. By using thisextremely wide range and high values for concentration of glucose, itwas possible to verify the trends in the data. FIG. 19A illustratesthree examples of transmission versus wavenumber over the primary regionof interest, wavenumbers 1000 to 1100 cm⁻¹, where glucose absorption ismost evident. FIG. 19B illustrates a plot of all of the FTIR data. The1000 mg/dl Concentration plot is the lowest line while water is the topmost. FIG. 19C illustrates the average areas under each curve, aroundthe two peaks in the FTIR spectral data, with the variation in solutionconcentration. All of the solutions were run at room temperature sothere were no other thermal effects. The same pattern is reveled if theconcentration is plotted as function of the height of the peak. Thisdisclosure contemplates that a Glucose Transmission Equation can bederived from the FTIR data of FIG. 19C. For example, the GlucoseTransmission Equation can be a polynomial expression that follows fromthe FTIR data. This expression can be a best fit model to the FTIR data.This best fit model to the FTIR data is shown by the solid line in FIG.19C.

Eye Model

A system incorporating the FLIR A325sc camera has been used to generatea large data set for study. FIG. 20 illustrates a data set from a systemincorporating the FLIR A325sc camera consisting of 103 readings. Thecorrelation matrix for this data is:

1 −0.13055 −0.13055 1

This is consistent with the negative correlations between radiance andBGV noted in the FTIR and surrogate eye studies.

The line in the plot is the best linear fit to the data and is itscharacteristic function:

CharacteristicFunct[BGV]=0.00431027914307337−1.387389894556692×10⁻⁷BGV

For this data set the mean values are {132.675, 0.00429187, 33.5383}with the standard deviations {25.11, 0.0000266844, 0.370433}. Note thatthe average temperature is 33.5 C and that σ=0.0000266844.

From the plot the scatter of the readings seems randomly distributedabout the CharacteristicFunct line. This can be seen by subtracting theCharacteristicFunct values from the data set which produces a noisedistribution as shown in FIG. 21. FIG. 22 illustrates the histogram ofthe noise. FIGS. 23A (probability density histogram and normaldistribution data fit) and 23B (randomly generated data probabilitydensity histogram and normal distribution data fit) show that the noiseis basically random which matches what is seen by the observations.

Having established randomness of the noise, it can be concluded that theaverage of many readings, perhaps 100, per evaluation session woulddecrease the scatter.

A theoretical expression for the CharacteristicFunct can be produced,which is designated as the EyeModel. This model is a function of BGV ashas the functional form of:

(EyeModel[BGV]=NLAFunc[BGV]*(GlucoseTramsissionEquation[BGV]*DatafitBB[33.5]))

That is the Eye Model is equal to a nonlinear correction factor, NLA,multiplied by the product of the GlucoseTramsissionEquation and BlackBody radiance at 33.5 C. As described above, the Glucose TransmissionEquation can be derived from Fourier transform infrared spectrometerdata.

Here the nonlinear correction factor expression is given by:

NLAFunc[BGV]=1.0080879109912388−0.00002801460985031528*BGV

This nonlinear correction factor varies from 1.006 to 1.002, adimensionless factor, over the BGV range of 70 to 250. So, this is asmall correction as noted in the FIG. 24, which illustrates thenonlinear correction factor as a function of BGV.

Even though the nonlinear correction factor is nearly one for this dataset, it is in general patient dependent and this represents the onlypoint where patient uniqueness appears.

The end result for the EyeModel for an extended range, without noise, isshown in FIG. 25.

Predicting Blood Glucose Values from the EyeModel

The EyeModel fits exactly the CharacteristicFunct[BGV] without the noisefield. To be a valid tool for BGV readings the noise does need to beincluded since any reading from a device will include it in the signal.The following plots summarize the findings to this point.

FIG. 26 shows experimental data, CharacteristicFunct and EyeModel withnoise plots. The noise is represented by using a random normallydistributed data field that is added to the EyeModel values.

FIG. 27 repeats the plots of FIG. 26 with the number of IR images andhence measurements increased by a factor of 10. These are averaged toform the noise field which is, as expected, narrowed.

Increasing the number of images taken per BGV evaluation improves themeasurement accuracy. In an optical glucometer, the data acquisitionstrategy may include the collection and averaging of about 50 images ormore. The time required would be in the seconds' range so a patientwould be unaware of the data collection and processing.

There are two types of data that for glucose measurements can be appliedfor BGV determinations. One is the experimental data, or the historicaldata, for particular patient. The other is a data set generated by usingthe EyeModel and statistical variations around it that match thehistorical data in terms of its range. In the following the searchalgorithm that can be used to identify the most probable glucose readingwill be demonstrated.

The search method is related to what could be called a nearest neighborsearch. However, in order to apply this technique, the basic data mustbe prepared and placed in a data space. The following expression showshow the distance data set is determined. In the first case, thehistorical data is used.

Historical Data:

This method uses the known BGV and multiplies the associated radiancevalues by 10000. This has the effect of a units change from radiance inWatts/cm² to Watts/m². This creates a two-dimensional space ofcomparable units and the distance between all of the points can then bedetermine using the Pythagorean method.

DistHistData==Table[{HistoricalData[[i,1]],10000HistoricalData[[i,2]]},{i,NumberofDataelements}]

i.e. the DistaHistData is the set BGV and Radiance in Watts/m² over alldata elements.

From this data, a distance matrix can be computed. However, this matrix,is an array of two-dimensional distance matrices. This is because thedistances are determined by ranging over the total number of historicaldata points and then over the range of possible BGV. The followingexample illustrates the method.

Suppose a patient wants to determine their blood glucose value and usesan infrared sensor (e.g., an optical glucometer system as describedherein) and the patient measures a radiance value of 0.004287 radiansper square cm. Applying the EyeModel, the predicted BGV is 167.75 mg/dL.

The historical data does not contain this radiance or Rad value, butthere are close values in the historical data i.e. {0.00428749,157.975}, {0.00428761, 128.6}, {0.00428794, 136.1}. These indicate BGVsomewhere between 126 and 158. The EyeModel prediction is outside ofthis range at 168.

The distance matrix is computed using

${DT} = {{{Table}\lbrack {{{Table}\lbrack {\{ \sqrt{( {{10000\;{Rad}} - {{DistHistData}\lbrack \lbrack {i,2} \rbrack \rbrack}} )^{2} + ( {P - {{DistHistData}\{ \{ {i,2} \rbrack \rbrack}} )^{2}} \},\{ {P,30,230} \}} \rbrack},\{ {i,38} \}} \rbrack}.}$

DT is the array of all distances between all historical data points andall possible points with a radiance of 0.004287 Watts/cm² and all BGVvalues. In this case, DT is a {38, 201, 1} array. Here “P” is a variablethat represents BGV that ranges over all possible integer values from 30to 230, while “i” ranges over all historical data points, here about100. The 5 smallest distance values, or those closest to the observedradiance value, 0.004287, are then found and listed;

{0.0254805, 0.045561, 0.0556082, 0.100436, 0.100579} which correspond tothe points:

{{158,0.00428749}, {130,0.00429156}, {154,0.00429197}, {136,0.00428794},{105,0.00428592}}.

The best match is a BGV of 158 which is, by design, within thehistorical data set.

Generated Data:

Much greater accuracy can be achieved by increasing the search data set.FIG. 28 illustrates a new data set, MeterData, obtained with theEyeModel expression plus randomly generated noise as described above.This data simulates the average of 40 IR images. The BGV range of 70 to500 is used in the example.

Again, DT is computed but now using the MeterData and in this case, DTis a {216, 111, 1} array. Here “P” ranges over all possible integer BGVsfrom 70 to 180 while “i” ranges over all 216 MeterData points. The Prange is reduced to speed calculations. The 5 smallest DT values (shownby dashed box in FIG. 29) are then found and listed:

{168,0.00428706}, {150,0.00428733}, {124,0.00428655}, {142,0.00428653},{136,0.00428753}

Now the closet point that matches for the BGV of 168. FIG. 29illustrates the results of the MeterData set obtained by EyeModel plusrandomly generated noise with 5 smallest DT values shown in the dashedbox. FIG. 30 is a blown up illustration of the 5 smallest DT valuesshown in FIG. 29, with the Radiance reading (horizontal line) andEyeModel plot (diagonal line). While 5 DT value points were identified,only one DT value is on the EyeModel plot line at 168.

Another way to interpret these results is that the average of the 5points is {144, 0.004287} with a standard deviation of {16.4317,4.53313*10⁻⁷}. BGV is therefore 144+/−16.4. The more probable valuewould be 144+16.4, 160.4, because this is closer to the EyeModel line.

System Incorporating FLIR LEPTON Camera

Referring now to FIGS. 6B-6D, an example system incorporating a FLIRLEPTON camera is shown. The basic system using the Lepton detectorsemploys a black body reference, ideally held at a fixed temperature nearthe average eye temperature, and the Lepton camera plus a computingdevice. The detector records the reference temperature and makes imagesof the patient's eye. As shown in FIG. 6B, the system is configured totake images of the patient's eye 651. The system includes an ocular tubehaving a moveable portion 652 and fixed portion 653. Additionally, thesystem includes a thermal reference 654 (i.e., black body (BB)) and anIR camera (i.e., FLIR LEPTON camera) 655. The system further includes ashutter 656. The shutter 656 is a movable assembly that allows the IRcamera 655 to observe the BB reference 654. It consists of an upper part(see FIG. 6C) that is the normal optical path between the eye 651 andthe IR camera 655. The lower part (see FIG. 6D) changes the optical pathsuch that radiation front the BB reference 654 goes directly to the IRcamera 655. The shutter 656 provides a means of obtaining the eyetemperature over the field of view. This can be accomplished by heatingor cooling the BB reference 654 until the ratio of EYE/BB value is one.This can improve the accuracy of the measurements.

Referring now to FIG. 31, images of a black body reference and patient'seye captured using a system described with respect to FIGS. 6B-6D areshown. FIG. 31 also illustrates the mask used to isolate a portion ofthe patient eye. The IR camera makes a series of 24 or more images(e.g., 80×40 pixel images) within a 6 second period that includes ablack body reference and the patient's eyes. The number of pixels usedfor the radiation detection in the eye is about 100, while for the blackbody 480 pixels are used. FIG. 32 illustrates a series of 24 imagescaptured as described above.

In this example, the first 6 images are of the BB and when reduced togrey scale (GS) pixel values yields and average of 0.9202 per pixel, theBB value. The last 9 images are of the eye center and has a gray scale(GS) pixel average of 0.8963, the EYE value. When coupled with the BBtemperature one obtains a data set such as:

{BB, EYE, Temperature}->{0.920156, 0.896342, 30.7}.

One example of typical data is of the form:

{0.8844190268700072, 0.8598140885984022, 31.4′} which corresponds to aBGV of 134 mg/dL. The BB and EYE readings are in average grey scalepixel values.

This data is then processed in terms of EYE/BB ratios and compared withthe BGV.

FIGS. 33-35 illustrate plots, smoothed using a moving average algorithm,represent the results. The data set used here includes 29 independentpoints.

FIG. 33 illustrates a plot that shows the expected trend, i.e. thatradiance decreases with increasing BGVs. Since all of the previous workhas been in terms of radians, the data shown in FIG. 33 has also beenconverted Radians versus BGV.

FIGS. 34 and 35 illustrate plots of eye to black body (BB) radiancereference ratio. The plots are not identical in general form because theconversion uses a black body function to determine radians per grayscale unit (GSU) pixels which is temperature dependent.

Both the plots in FIGS. 34 and 35 show a “turn up” for BGV above 160mg/dL. This appears to be noise in the data and should not be presentwhen more data is included. In particular, for the diabetic test subjectstudied here BGV above 160 are rare, hence the higher values here do nothave the benefit of a larger population average.

This effect is reduced when the radiance ratios are considered as shownin the following FIG. 35. This data has been smoothed with a movingaverage algorithm. There is a strong correlation between this ratio andBGV.

Even though the FLIR LEPTON camera includes a VOX sensor, it is moresusceptible to signal drifting than a system including more complexcamera (e.g., FLIR A325sc camera). One way to address signal drift is touse the ratio of EYE/BB which is invariant with respect to signaldrifting but not to eye radiance variations. Continuous monitoring of ablack body standard would facilitate a reasonably accurate diagnosticmeasurement.

FIGS. 36A-36D illustrate an example handheld optical glucometer used tocollect the data shown in FIGS. 33-35. The handheld optical glucometerincludes a device body 670 in which an IR camera 675 (i.e., FLIR LEPTONcamera) is mounted. The device body 670 is designed to maintain the eyeat a fixed and stable distance from the IR camera 675. This design alsofits into the eye socket so that the eye will always be centered in theIR camera 675 field of view. The eye is about 4 cm from the IR camera675 so there is no contact. One does not need to apply high pressure tohold the device in place, so there is no discomfort to the patient. Asdescribed herein, the IR camera 675 interfaces with a computing device(e.g., computing device 600 of FIG. 6E) for image processing andanalyses. This disclosure contemplates that the computing device can bepart of, or external to, the handheld optical glucometer.

Those skilled in the art will recognize, or be able to ascertain usingno more than routine experimentation, many equivalents to the specificembodiments of the invention described herein. Such equivalents areintended to be encompassed by the following claims.

Although the subject matter has been described in language specific tostructural features and/or methodological acts, it is to be understoodthat the subject matter defined in the appended claims is notnecessarily limited to the specific features or acts described above.Rather, the specific features and acts described above are disclosed asexample forms of implementing the claims.

What is claimed is:
 1. An optical glucometer apparatus comprising: athermographic device that is configured to passively receivemid-infrared (MIR) electromagnetic emissions from an eye of a subject,and a computing device that is communicatively connected to thethermographic device, wherein the thermographic device is configured tocommunicate the MIR electromagnetic emissions from the eye of thesubject to the computing device, and wherein the computing device isconfigured to compare the MIR electromagnetic emissions from the eye ofthe subject to standard control values to estimate glucose levels of thesubject.
 2. The apparatus of claim 1, wherein the thermographic deviceis a thermographic imaging device.
 3. The apparatus of claim 2, whereinMIR electromagnetic emissions are captured by at least one image takenof the subject's eye by the thermographic imaging device.
 4. Theapparatus of claim 2, wherein the thermographic imaging device is aninfrared camera.
 5. The apparatus of claim 2, wherein the thermographicimaging device is a microbolometer.
 6. The apparatus of claim 5, whereinthe microbolometer has a sensitivity that is at least comparable to avanadium oxide (VOX) or amorphous silicon (a-Si) microbolometer.
 7. Theapparatus of claim 5, wherein the microbolometer comprises a focal planearray of about 100×100 active pixels.
 8. The apparatus of claim 1,wherein the thermographic device is a bolometer-type infrared imagingdevice.
 9. The apparatus of claim 1, wherein the thermographic device isa mid-infrared (MIR) sensor.
 10. The apparatus of claim 1, wherein theMIR electromagnetic emissions are in a wavelength range from about 8 μmto about 11 μm.
 11. The apparatus of claim 1, further comprising a frameconfigured to align a sensor of the thermographic device in front of thesubject's eye.
 12. The apparatus of claim 1, wherein the computingdevice is incorporated into a handheld electronic device.
 13. Theapparatus of claim 1, wherein the computing device is further configuredto calculate a radiance value based on the MIR electromagneticemissions.
 14. The apparatus of claim 1, further comprising a continuousmedicament delivery device in data communication with the apparatus,configured to receive the blood glucose value from the apparatus, andfurther configured to deliver insulin to the subject for glucosecontrol.
 15. A method for detecting blood glucose levels in a subject,comprising passively quantifying mid-infrared (MIR) electromagneticemissions from the eye of the subject, and comparing the MIR emissionsto standard control values to estimate glucose levels in the eye. 16.The method of claim 15, wherein the MIR emissions are detected at awavelength of about 8 to 11 μm.
 17. The method of claim 15, wherein theMIR emissions are detected at a wavelength of about 10 μm.
 18. Themethod of claim 15, wherein the MIR emissions are detected using abolometer-type infrared imaging device.
 19. The method of claim 15,wherein the MIR emissions are detected using a microbolometer infraredcamera.
 20. The method of claim 15, further comprising assaying a bloodsample from the subject to measure blood glucose levels if abnormalglucose levels are estimated.
 21. The method of claim 15, furthercomprising adjusting glucose levels in the subject based on theestimated glucose levels.
 22. An optical glucometer apparatuscomprising: a mid-infrared (MIR) sensor; and a processor configured tomeasure blood glucose concentration in a subject; and a computerizedmemory that stores a set of control voltage values; wherein theprocessor comprises computer implemented instructions to: passivelyreceive, during a measurement cycle, a voltage measurement from the MIRsensor corresponding to voltage induced by MIR radiation emitted from aneye of a subject; and correlate the voltage measurement to the controlvoltage values equal to the voltage measurement.
 23. The apparatus ofclaim 22 wherein the voltage measurement includes multiple voltagemeasurements and wherein the processor further comprises computerimplemented instructions to: integrate the multiple voltage measurementsand produce a single voltage value for the measurement cycle; andcalculate an average voltage measurement of the single voltage valueacross a plurality of measurement cycles; and wherein the voltagemeasurement for correlation is the average voltage measurement.
 24. Theapparatus of claim 22 wherein the set of standard control valuescomprises a respective average of control voltage values induced at theMIR sensor for MIR emitted through respective transmission media havingknown glucose concentrations.
 25. The apparatus of claim 22, furthercomprising a continuous medicament delivery device in data communicationwith the apparatus, configured to receive the blood glucose value fromthe apparatus, and further configured to deliver insulin to the subjectfor glucose control.